Matsumoto K, Yamauchi T, Ichikawa M, Masuda Y, Ogawa K, Arai T, Ito M, Yamashita Y
Department of Internal Medicine, Toki General Hospital, Gifu, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Mar;34(3):345-9.
A 25-year-old with acute lymphoblastic leukemia (FAB:L2) received an allogeneic bone marrow transplant from an HLA-identical sibling during the first remission. Despite administration of adequate immunosuppressant drugs, active chronic graft-versus-host disease developed and continued. The patient complained of progressive dry coughing and breathlessness on exertion 18 months after the transplant and severe hyperlucency and multiple bullae were observed on a chest X-ray film. Three years after the transplant, recurrent bilateral pneumothorax developed and lung cysts were resected twice. Histological examination revealed bronchiolitis obliterans. We speculate that post-transplant bronchiolitis obliterans caused multiple bullae to form by a check-valve mechanism, which then led to recurrent bilateral pneumothorax.
一名25岁的急性淋巴细胞白血病患者（FAB:L2）在首次缓解期接受了来自 HLA 配型相同的同胞的异基因骨髓移植。尽管使用了足够的免疫抑制药物，但仍发生并持续存在活动性慢性移植物抗宿主病。患者在移植后18个月出现进行性干咳和活动后气促，胸部X线片显示严重透亮度增加和多个肺大疱。移植后三年，反复发生双侧气胸，肺囊肿两次切除。组织学检查显示闭塞性细支气管炎。我们推测，移植后闭塞性细支气管炎通过单向活瓣机制导致多个肺大疱形成，进而导致反复双侧气胸。
